At a historic Board of Directors meeting in December, CalOptima Health’s Board approved the funding for several major programs to benefit member care. A significant portion of the funding is directed towards incentives for providers in recognition of the pivotal role they play in supporting our members’ health.
$50 Million to Fund Cancer Screening
The Board allocated $50.1 million to fund a Comprehensive Community Cancer Screening and Support Program for Medi-Cal Members designed to achieve the lowest incidence rate nationwide for late-stage breast, cervical, colon and certain lung cancers. This is the single largest investment in a disease prevention program in the health plan’s history. “With rare exception, no one should die from breast, cervical or colon cancer, and many heavy smokers should not die from lung cancer,” said Richard Pitts, D.O., Ph.D., Chief Medical Officer. “CalOptima Health will be creative and relentless in going after these four specific cancers that are relatively easy to detect and are treatable when found in the early stages. This is our Orange County cancer moonshot.”
$5 Million to Fund NAMI Peer Program
To support mental health hospital discharges and improve access to behavioral health services, the Board also funded a $5 million grant for the National Alliance for Mental Illness (NAMI) Orange County to pair trained peer mentors with CalOptima Health members. “Connecting our members with trained, experienced individuals who can offer invaluable guidance with navigating the mental health system is a major step toward making behavioral health services more accessible,” said Carmen Katsarov, LPCC, CCM, CalOptima Health Executive Director of Behavioral Health Integration. Steve Pitman, President of NAMI Orange County agreed: “Our NAMI mentors will walk alongside CalOptima Health members on their journey to recovery, offering valuable support while demonstrating through their own lived experience that recovery is possible. We look forward to this partnership making a difference in the community.”
$153 Million to Fund a Hospital Quality Program
CalOptima Health’s Board also appropriated up to $153.5 million for a five-year Hospital Quality Program to measure and incentivize quality hospital care for members. Reflecting the agency’s commitment to breakthrough improvement in all quality measures, the program aims to provide data-driven feedback to hospitals on their quality improvement efforts, while recognizing and rewarding those that demonstrate quality performance. It will also identify areas for improvement and for working collaboratively with hospitals to ensure members receive quality care, including increased patient safety and performance-driven processes. “I am very excited about this [program] where we have really listened to our hospital providers,” said CalOptima Health Board Director Isabel Becerra during the December meeting. Added Board Director Clayton Chau, M.D., Ph.D.: “[It] speaks to how much we value what we do and how much we care for the well-being of our members.”
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